Hyperparathyroidism

ʻO Hyperparathyroidism kahi maʻi kahi i loaʻa ai i nā puʻupuʻu parathyroid i kou ʻāʻī ke hana i ka nui o ka hormone parathyroid (PTH).

Aia he 4 mau puʻuwai parathyroid liʻiliʻi i ka ʻāʻī, kokoke a pili paha i ka ʻaoʻao hope o ka pona thyroid.

Kōkua nā palahalaha parathyroid e kāohi i ka hoʻohana ʻana o ka calcium i ke kino. Hana lākou i kēia ma ka hana ʻana i ka hormone parathyroid (PTH). Kōkua ʻo PTH i ka mālama ʻana i ka pae o ka pākika, phosphorus, a me ka wikamina D i loko o ke koko a me ka iwi.

Ke haʻahaʻa loa ka pae calcium, pane ka kino i ka hana ʻana i PTH hou aʻe. ʻO kēia ke kumu e piʻi ai ka pae calcium i ke koko.

Ke ulu a hoʻokahi a ʻoi paha o nā gland parathyroid, alakaʻi ia i ka nui o PTH. ʻO ka pinepine, ʻo ke kumu he tumo benign o nā gland parathyroid (parathyroid adenoma). Kūleʻa kēia mau puʻupuʻu maikaʻi a hana ʻia me ka ʻole o kahi kumu i ʻike ʻia.

• Kūleʻa ka maʻi i nā poʻe ma mua o 60 mau makahiki, akā hiki ke hana ʻia i nā ʻōpio ʻōpio. ʻO ka hyperparathyroidism i ka wā kamaliʻi he ʻano ʻē.
• ʻOi aku ka hopena o nā wahine ma mua o nā kāne.
• Hoʻonui ka uila i ke poʻo a me ka ʻāʻī i ka makaʻu.
• ʻO kekahi mau syndrome genetic (mau endocrine neoplasia I) e loaʻa iā ia he hyperparathyroidism.
• I nā hihia kakaikahi loa, hoʻokumu ʻia kēia maʻi e ka maʻi ʻaʻai parathyroid.

ʻO nā kūlana olakino e hoʻohaʻahaʻa i ke kōpaʻa koko a i ʻole hoʻonui ʻia ka phosphate hiki ke alakaʻi i ka hyperparathyroidism. ʻO nā kūlana maʻamau e pili pū me:

• Nā kūlana e paʻakikī i ke kino e hemo i ka phosphate
• Hewa ʻole nā ​​hakuʻala
• ʻAʻole lawa ka calcium i ka papaʻai
• Nui ka nui o ka calcium i nalowale i ka mimi
• Nā maʻi Wikamina (hiki i nā keiki ʻai ʻole i nā ʻano meaʻai like ʻole, a i ka poʻe ʻelemākule i lawa ʻole ka lā o ka lā i ko lākou ʻili a i ʻole ka loaʻa maikaʻi ʻole o ka huaora D mai ka meaʻai e like me ma hope o ke kahakaha bariatric)
• Hoʻopilikia i ka omo ʻana i nā meaola mai ka meaʻai

Hoʻomaopopo pinepine ʻia ʻo Hyperparathyroidism e nā hōʻike koko maʻamau ma mua o ka hiki ʻana o nā hōʻailona.

Hoʻokumu ʻia nā ʻōuli e ka hōʻino ʻia o nā mea mai ke kiʻekiʻe o ka calcium i loko o ke koko, a i ʻole ka nalo ʻana o ka calcium mai nā iwi. Hiki i nā ʻōuli ke hoʻohui pū:

• ʻEha iwi a palupalu paha
• Kaumaha a me ka poina
• Manaʻo luhi, maʻi, a nāwaliwali
• ʻO nā iwi lahilahi o nā lālā a me ka iwi kuamoʻo i hiki ke haki maʻalahi
• Hoʻonui i ka nui o ka mimi i hana ʻia a pono e mimi pinepine pinepine
• Pohaku hakuʻala
• Nusea a me ka lilo o ka makemake

E hana ka mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i nā ʻōuli.

ʻO nā hoʻāʻo e hana ʻia ana paha:

• Hōʻaʻo koko PTH
• Hōʻike koko kalepona
• Alkaline phosphatase
• Pākuʻi
• 24-hola mimi hoʻāʻo

Hiki i nā hoʻāʻo iwi iwi a me ka iwi mineral density (DXA) ke kōkua e ʻike i ka nalo ʻana o ka iwi, nā haki, a i ʻole ka palupalu ʻana o ka iwi.

X-kukuna, ultrasound, a i ʻole CT scans o nā puʻupaʻa a i ʻole ka mimi ke hōʻike i nā waihona calcium a i ʻole kahi paʻa.

Hoʻohana ʻia ʻo Ultrasound a i ʻole ka ʻimi lāʻau nukleo o ka ʻāʻī (sestamibi) e ʻike ai inā he tumo benign (adenoma) i loko o kahi aʻa parathyroid ke kumu o ka hyperparathyroidism.

Inā loaʻa iā ʻoe kahi kiʻekiʻe o ka calcium i hoʻonui iki ʻia a ʻaʻohe ou mau ʻōuli, koho paha ʻoe e loaʻa i nā loiloi maʻamau a mālama ʻia paha.

Inā hoʻoholo ʻoe e mālama i ka lāʻau, hoʻopili pū paha ia:

• Ke inu nei i nā wai hou aʻe e pale ai i nā pōhaku hakuʻala mai ka hana ʻana
• Hoʻoikaika kino
• ʻAʻole lawe i kahi ʻano o ka pila wai i kapa ʻia ʻo thiazide diuretic
• ʻO Estrogen no nā wahine i hele i loko o ka menopause
• Ke ʻoki ʻana e wehe i nā gland overactive

Inā loaʻa iā ʻoe nā hōʻailona a kiʻekiʻe loa paha kāu pae calcium, pono ʻoe i ke ʻoki e wehe i ka gland parathyroid e hana nui nei i ka hormone.

Inā loaʻa ʻoe i ka hyperparathyroidism mai kahi ʻano olakino, hiki i kāu mea hāʻawi ke kuhikuhi i ka lāʻau D, inā he haʻahaʻa vitamona D kāu.

Inā hyperparathyroidism mea ma muli o ka hakuʻala hoʻokō ʻole, lapaʻau hiki pū me:

• ʻO ke kalima keu a me ka huaola D
• Ke pale nei i ka phosphate i ka papaʻai
• ʻO ka cinacalcet lāʻau (Sensipar)
• Dialysis a i ʻole ke kuʻi ʻōiwi
• ʻO ke kīnā o Parathyroid, inā kiʻekiʻe kiʻekiʻe ka pae parathyroid

Pili ʻo Outlook i ke kumu o hyperparathyroidism.

Nā pilikia lōʻihi hiki ke hana ʻia inā ʻaʻole mālama maikaʻi ʻia ʻo hyperparathyroidism me:

• Lilo nā iwi i nāwaliwali, hōʻano, a i ʻole hiki ke haki
• ʻO ke koko kiʻekiʻe a me nā maʻi puʻuwai
• Pohaku hakuʻala
• Maʻi maʻi ʻōuli lōʻihi

Hiki i ke kahakaha glanda parathyroid ke hopena i ka hypoparathyroidism a me ka hōʻino ʻana i nā ʻalolo e kaohi ana i nā kaula leo.

Hypercalcemia pili i ka Parathyroid; Osteoporosis - hyperparathyroidism; ʻO ka lahilahi iwi - hyperparathyroidism; Osteopenia - hyperparathyroidism; Kiʻekiʻe pae kalipuna - hyperparathyroidism; Maʻi maʻi ʻōniʻoniʻo - hyperparathyroidism; Hewa ʻiʻo - hyperparathyroidism; Overactive parathyroid; Ka nele o ka wikamina D - hyperparathyroidism

• Nūʻau parathyroid

ʻO Hollenberg A, Wiersinga WM. Nā maʻi Hyperthyroid. I: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 12.

ʻO Thakker RV. ʻO nā gland parathyroid, hypercalcemia a me hypocalcemia. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 232.